Florida passed two major medical debt laws in 2025 that took effect in 2026, giving patients stronger protections against aggressive hospital collection tactics. At the same time, the state's two largest hospital systems, AdventHealth and HCA Florida, maintain charity care programs that can eliminate or dramatically reduce what you owe. As of 2026, knowing both the law and each hospital's financial assistance policy is the fastest way to cut a Florida hospital bill down to size.
Quick Answer: Florida law now limits when hospitals can take extraordinary collection actions against patients, and both AdventHealth and HCA Florida offer free care to patients at or below 200-250% of the federal poverty level. The CoveredUSA Bill Analyzer can scan your hospital bill line by line to surface errors, overcharges, and charity care options specific to Florida before you pay anything.
What Florida's 2026 Medical Debt Laws Actually Say
Florida did not pass a single sweeping medical debt forgiveness law in 2025. Instead, the legislature passed two targeted bills that together create meaningful new patient rights.
CS/HB 547, signed by Governor DeSantis and effective July 1, 2025, tightened rules around "extraordinary collection actions" (ECAs). Before this law, ECA restrictions only applied to bills covered by a hospital's financial assistance policy. HB 547 expanded those restrictions to cover ALL bills for care, regardless of whether the patient had applied for financial assistance. Under the 2026 rules:
- Florida hospitals and ambulatory surgical centers (ASCs) cannot sue patients, report debt to credit bureaus, or take wage garnishment action until after they have completed their financial assistance screening process.
- Hospitals may only sell medical debt without the standard 30-day notice if: (1) the debt carries no interest or fees, (2) the debt buyer does not take any further ECAs, and (3) the debt is returned if it qualifies as charity care under the financial assistance policy.
SB 656, also effective July 1, 2025, reinforced those restrictions and clarified that all bills for care, not just those flagged as potential charity care, are covered by the ECA framework.
A separate 2024 Florida law (effective July 1, 2024) set a three-year statute of limitations on medical debt from hospitals, ASCs, and urgent care centers. That clock starts when the facility refers the debt to a third-party collector, not the date of service or first missed payment. This is a significant protection: debt collectors in Florida can no longer pursue hospital bills indefinitely.
Also effective January 1, 2026: Florida now requires healthcare facilities to refund any patient overpayment within 30 days of determining the overpayment occurred. If a hospital charged you too much and later corrected it, they must send your money back promptly, not apply it as a credit to future bills.
According to cms.gov, federal No Surprises Act protections also apply in Florida, blocking balance billing for emergency services and out-of-network care at in-network facilities. Those protections layer on top of Florida's state-level rules.
Florida Charity Care Income Limits: What the Law Requires vs. What Hospitals Offer
Florida law requires licensed hospitals to provide charity care to uninsured patients below 100% of the federal poverty level (FPL). However, every major Florida hospital system offers well above this minimum. The practical income limits that matter in 2026 are set by each hospital's own financial assistance policy, not by state law.
2026 Federal Poverty Level Reference Table (Florida)
Florida uses the standard 48-state FPL. These are the 2026 figures published by aspe.hhs.gov in January 2026:
| Household Size | 100% FPL (2026) | 200% FPL | 250% FPL | 400% FPL |
|---|
| 1 | $15,960 | $31,920 | $39,900 | $63,840 |
| 2 | $21,640 | $43,280 | $54,100 | $86,560 |
| 3 | $27,320 | $54,640 | $68,300 | $109,280 |
| 4 | $33,000 | $66,000 | $82,500 | $132,000 |
| 5 | $38,680 | $77,360 | $96,700 | $154,720 |
| 6 | $44,360 | $88,720 | $110,900 | $177,440 |
| 7 | $50,040 | $100,080 | $125,100 | $200,160 |
| 8 | $55,720 | $111,440 | $139,300 | $222,880 |
Table: 2026 Federal Poverty Level thresholds used by Florida hospitals for charity care screening.
AdventHealth Florida: Charity Care Rules in 2026
AdventHealth operates more than 50 hospitals and facilities across Florida, including AdventHealth Orlando, AdventHealth Tampa, AdventHealth Daytona Beach, and AdventHealth Ocala. Their financial assistance policy applies systemwide to Florida facilities.
Free care (100% reduction): Patients who received emergency or medically necessary care and have annual household income at or below 250% of the 2026 FPL qualify for complete forgiveness of the balance after insurance. For a family of four in Florida, that means annual income at or below $82,500 in 2026.
Sliding scale above 250% FPL: AdventHealth offers discounted care to patients with income above 250% FPL on a sliding scale basis. The exact discount percentage depends on income relative to FPL and documented financial hardship. Patients above 250% FPL should still apply. The system has discretion to provide assistance based on expenses and assets.
How to apply: Contact AdventHealth billing at 800-462-0490 or ask at the hospital's patient financial services desk. An application and income documentation are required.
Key rule: AdventHealth cannot take extraordinary collection action against you before offering you a financial assistance application and reviewing your eligibility. If you received a bill without anyone offering you a charity care application, that is a violation of Florida's 2026 ECA rules.
HCA Florida: Charity Care Rules in 2026
HCA Florida Healthcare operates more than 50 hospitals across the state, including HCA Florida Kendall Hospital (Miami), HCA Florida Brandon Hospital, HCA Florida Orange Park Medical Center, and HCA Florida Capital Medical Center (Tallahassee). HCA Healthcare's parent-level policy applies.
Free care (100% reduction): Patients with household income between 0 and 200% of the 2026 FPL who received non-elective care qualify for a full charity discount. For a family of four, that is income up to $66,000 in 2026.
Expanded financial assistance (201% to 400% FPL): Patients with balances over $1,500 and household income between 201% and 400% FPL may qualify for HCA's expanded financial assistance program. Under this policy, out-of-pocket liability is capped at 4% of annual income on a sliding scale. A Florida family of four earning $90,000 would have their liability capped at roughly $3,600, regardless of the bill's face value.
How to apply: Contact HCA Florida's billing department directly through your specific hospital or via the HCA Florida patient financial resources portal. You will need income documentation and information about your household size.
AdventHealth vs. HCA Florida Charity Care Comparison (2026)
| AdventHealth Florida | HCA Florida |
|---|
| Free care threshold | 250% FPL | 200% FPL |
| Family of 4 free care income limit (2026) | $82,500 | $66,000 |
| Sliding scale upper limit | Discretionary above 250% | 400% FPL |
| Sliding scale cap method | Percentage discount | 4% of annual income cap |
| Minimum balance for expanded assistance | Not published | $1,500 |
| Phone | 800-462-0490 | Per hospital |
Table: AdventHealth vs. HCA Florida charity care thresholds, 2026.
Orlando Health and Other Florida Systems
Orlando Health (not part of AdventHealth or HCA) also provides financial assistance for Florida patients. Orlando Health follows No Surprises Act billing protections under federal law and offers its own charity care program. The Florida Hospital Association's charity care issue brief notes that Florida nonprofit hospitals collectively provided over $1 billion in charity care in recent years.
When your hospital is not AdventHealth or HCA, the process is the same: ask for a Financial Assistance Policy (FAP) application, provide income documentation, and request a formal eligibility determination before making any payment.
How the CoveredUSA Bill Analyzer Can Help
Before you call the billing department or negotiate a payment plan, use the CoveredUSA Bill Analyzer to review your itemized bill. The CoveredUSA Bill Analyzer compares each line on your bill to Medicare benchmark rates and flags charges that exceed standard rates, duplicate line items, and services that should have been included in a bundled rate. Many Florida patients discover that 30% or more of their bill contains correctable errors before they even reach the charity care conversation.
Upload your hospital bill to the free CoveredUSA Bill Analyzer to find errors, overcharges, and charity care options in 30 seconds.
How to Apply for Florida Hospital Financial Assistance in 2026
Florida law and hospital policies create a defined process. Follow these steps to maximize your chance of getting your bill reduced or eliminated.
Application window: Florida hospitals are required to give patients a reasonable opportunity to apply for financial assistance before pursuing collections. Most Florida hospitals allow up to 240 days from the first billing statement to submit a financial assistance application. Apply as early as possible. Do not wait for a collection notice.
Step-by-Step Application Process
- Request your itemized bill in writing. You are entitled to an itemized statement. This is the document to review for errors before you apply for assistance.
- Request the Financial Assistance Policy (FAP) application. Ask billing by phone or in person. Both AdventHealth and HCA Florida are required to have applications available at the hospital and on their websites.
- Gather income documentation. You will need the most recent tax return, recent pay stubs (2-3 months), bank statements, and documentation of other income sources. For household members, you need documents for all adults in the household.
- Complete and submit the application. Include all required documents. Missing documents are the most common reason applications are delayed or denied.
- Request a written determination. The hospital must provide a written notice of their decision. Keep this for your records.
- Appeal if denied. Both AdventHealth and HCA Florida have appeal processes. If denied, request the specific reason in writing and ask whether any additional documentation could change the determination.
- Negotiate a payment plan if partially approved. If you do not qualify for full charity care, ask about a payment plan with no interest. Florida law prohibits extraordinary collection actions while you are in compliance with an agreed-upon payment plan.
Documents You Will Need
- Most recent federal tax return (Form 1040)
- Recent pay stubs (last 2-3 months) for all employed household members
- Bank statements (last 2-3 months)
- Proof of any Social Security, disability, or unemployment income
- Proof of household size (birth certificates, utility bills showing address)
- Any explanation of benefits (EOB) from your insurance, if applicable
Common Reasons Applications Get Denied
- Missing income documentation for one or more household members
- Application submitted after the facility's deadline (most are 240 days from first bill)
- Income reported without including all household members
- Failure to report non-wage income (freelance, rental, Social Security)
- Balance has already been sent to a third-party collector (may require retrieval)
Florida Medical Debt and Your Credit Report in 2026
Florida patients benefit from both state law and voluntary credit reporting industry changes. As of 2026:
- Medical debt under $500 does not appear on credit reports (voluntary industry change).
- Paid medical collections are removed from credit reports.
- New medical debt has a one-year grace period before it can appear on a credit report, giving patients time to resolve bills or apply for assistance.
- Unpaid medical collections over $500 that are more than one year old can still appear on Florida credit reports.
The three-year statute of limitations on Florida hospital debt (effective July 1, 2024) means that collectors cannot sue you to collect medical debt that is more than three years old, counting from when the facility referred the debt to a collector per Florida Statutes.
Frequently Asked Questions
What income qualifies for free hospital care at AdventHealth Florida in 2026?
AdventHealth Florida provides free care (100% forgiveness) to patients with household income at or below 250% of the 2026 federal poverty level after insurance has paid. For a single person, that is $39,900 per year. For a family of four, that is $82,500 per year. These thresholds apply to emergency and medically necessary care.
What income qualifies for free hospital care at HCA Florida in 2026?
HCA Florida provides free charity care to patients with income at or below 200% of the 2026 FPL. For a single person, that is $31,920 per year. For a family of four, that is $66,000 per year. Patients between 201% and 400% FPL with balances over $1,500 may qualify for the expanded financial assistance program, which caps liability at 4% of annual income.
Does Florida law require hospitals to offer charity care?
Florida requires licensed hospitals to provide charity care to uninsured patients below 100% of the federal poverty level. However, major systems like AdventHealth and HCA Florida voluntarily set their free care thresholds at 250% and 200% FPL respectively, far above the state minimum. The 2025 laws (HB 547 and SB 656, effective July 2025) do not set charity care income limits but do restrict when hospitals can pursue collections.
Can a Florida hospital sue me for medical debt in 2026?
Yes, but with restrictions. Florida's 2024 law set a three-year statute of limitations on hospital medical debt, measured from when the facility refers the debt to a collector. Florida's 2025 laws (HB 547 and SB 656) prohibit extraordinary collection actions, including lawsuits, while a patient is in compliance with a payment plan or while a financial assistance application is pending. If a hospital sues you without first completing the financial assistance screening process, that may violate Florida law.
What is an "extraordinary collection action" under Florida law?
Under Florida law as of 2026, extraordinary collection actions (ECAs) include: selling a patient's debt to a third party, reporting the debt to a consumer credit reporting agency, deferring or denying medically necessary care due to unpaid balances, taking legal action including lawsuits, and taking adverse action against a patient's credit. These actions are restricted before the hospital completes its financial assistance review.
How long does a Florida hospital have to offer me financial assistance?
Most Florida hospitals allow applications for up to 240 days from the first billing statement. Some hospitals use a shorter window. Request your Financial Assistance Policy document from the billing department as soon as you receive a bill to confirm the deadline at your specific facility.
Does the No Surprises Act apply to Florida hospitals?
Yes. The federal No Surprises Act applies in Florida and protects patients from balance billing for emergency care and out-of-network care received at in-network hospitals and ASCs. Patients are also entitled to a Good Faith Estimate of expected costs before scheduled procedures. HCA Florida posts its No Surprises Act protections on its patient financial resources page per cms.gov/nosurprises.
What should I do if I received a bill from AdventHealth or HCA Florida and cannot afford it?
Do not ignore the bill. Instead: (1) request an itemized statement, (2) use the CoveredUSA Bill Analyzer to check for overcharges, (3) request and complete a financial assistance application immediately, (4) provide all required income documentation, and (5) ask about a zero-interest payment plan while your application is reviewed. Florida law protects you from collection action while a financial assistance application is pending.
